Teratogen Flashcards

1
Q

What percentage of live births have major birth defects?

A

3 - 4%

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2
Q

When do chromosomal abnormalities take place?

A

Chromosomal abnormalities preclude conception.

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3
Q

When does microcephaly develop?

A

Can develop relatively late in pregnancy

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4
Q

When does cleft palate typically occur?

A

Occurs towards the end of the first trimester

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5
Q

When do neural tube defects typically occur?

A

Occur in earliest weeks of gestation

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6
Q

What does Sonic hedgehog do?

A

Mammalian morphogen, regulating organogenesis, including growth of digits, brain organisation, sex organ differentiation, and lots more.

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7
Q

Where is sonic hedgehog produced?

A

In the notocord by node cells.

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8
Q

What type of protein is Sonic hedgehog?

A

It is a signalling morphogen. Determines cell responses in development: Key role in regulating vertebral organogenesis, growth of digits on limbs and brain organisation.

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9
Q

What is the job of Shh?

A

Important in the adult

Controls division of adult stem cells

Implicated in cancer development

Role in energy metabolism

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10
Q

What happens when Shh is mutated?

A

Mutations in SHH gene cause holoprosencephaly due to loss of ventral midline (it is a lethal mutation)

No Shh = no transcription of hedgehog-responsive genes.

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11
Q

What is the role of BMP4?

A

Involved in limb development

Knock outs are embryonic lethal

Mutants fail to properly form the mesoderm

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12
Q

Which fingers are SHH dependent?

A

The thumb is not SHH dependent.

The 3 most medial fingers are SHH dependent.

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13
Q

What happened to rhesus monkeys given thalidomide on the 26th day of pregnancy?

A

Abnormalities in forelimb, lower jaw, ear, and tail in 100 day rhesus monkey foetus.

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14
Q

How do teratogens affect birth defects?

A

Teratogens do not uniformly increase rates of all birth defects. They instead increase rates of specific defects:

Thalidomide affects limbs

Isotretinoin affects ear, CNS, and heart

Valproic acid affects neural tube etc

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15
Q

How does timing of teratogen affect what body system is hurt?

A

Each stage affects a specific system. Early stage affects CNS, Heart, and upper limbs.

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16
Q

How was thalidomide sold?

A

As a racemic mixture of glutamic acid derivative 1:1 mix of enantiomers (R, S) R(+) acts as a sedative mediated by sleep receptors in the forebrain. S(-) potentially inhibits the release of tumour necrosis factor alpha (TNFalpha) this is why thalidomide caused teratogenic effects.

17
Q

What is the role of TNF-alpha?

A

induces NF-kappaB and activates gene expression for:

Cell growth

Suppression of apoptosis

Metastasis

Immune and inflammatory response.

Thalidomide decreases TNFalpha production by accelerating mRNA degradation.

18
Q

What does BMP do to limb development?

A

BMP regulates level of apoptosis & have balance to give proper limb bud formation from AER.

BMP upregulates Smad which upregulates Msx-2.

BMP is inhibited by NFkappaB

19
Q

What does NFkappaB do to BMP?

A

It decreases levels of BMP which makes it turn off apoptosis.

20
Q

What does thalidomide do?

A

Increases ROS which leads to less active NF-kappaB which results in de-repression of BMP which results in apoptosis and limb truncations.

21
Q

What are other uses of thalidomide?

A

Inhibits angiogenesis making it useful in cancer.

It is anti-inflammatory

Stimulates the immune system - against tuberculosis in AIDS patients.

Can be used to treat 1 form of leprosy called Erythema Nodosum Leprosum (ENL) which is very effective

22
Q

What are the factors that influence the extent of foetal damage?

A

Time and duration of exposure: Exposure during organogenesis will result in major impairments and malformations.

Genetic susceptibility: Genotype of mother and foetus play an important role. Way mother metabolises a certain drug will determine what and how much the foetus is exposed to

23
Q

What kinds of diseases in the mother can result in malformations?

A

Rubella

Herpes simplex

AIDS

Chickenpox

Zika